Flexor tendon injuries

Flexor tendons are the tendons on the palm side of the wrist and hand that enable you to bend or flex your fingers and wrist. Flexor tendon injuries are uncommon injuries that usually occur from a traumatic laceration to the palm side of the hand or finger, but can occasionally occur from a trauma without a cut or laceration. In most cases, flexor tendon injuries require surgical treatment to regain motion of the injured finger and maximize long term function.

Causes and risk factors

A deep cut or laceration in the wrist, palm, or finger

Closed, hyperextension injury to the finger

Certain medical conditions, such as rheumatoid arthritis, may place patients at a higher risk of developing a flexor tendon injury

Symptoms

Pain and swelling in the wrist/palm/hand

Inability to flex (bend) a digit or one of the joints of a digit

Diagnosis and treatment

In most cases, the diagnosis is made clinically based off your physical examination findings. In rare cases, additional imaging such as MRI or ultrasound is used to confirm the diagnosis. If a flexor tendon is completely lacerated or ruptured, then surgery is generally advised to regain motion and maximize long term function. While overall outcomes with surgery are good, rehabilitation can be lengthy and requires dedicated hand therapy. Most patients will regain the ability to use the affected digit, but the motion may not return to normal. Occasionally patients develop significant scar tissue that can affect their function and may require additional surgery to release.